God, AIDS, Africa & HOPE

Reflections / Gedanken

The Berlin Patient – cured or not cured?

Maybe you have heard about the so-called “Berlin” patient who has been cured of HIV. Or maybe not? What is actually happening with him and what does it mean for the research? Are we close to find the key to win over the battle? Please read here more about this interesting case.

Filed under: HIV and AIDS, HIV Treatment, Medical and Research, , , , , , ,

Sangamo’s Possible ‘Functional Cure’ Gene Therapy

AIDSmeds reports that Sangamo BioSciences has begun new clinical studies of its promising gene therapy SB-728-T, a potential “functional cure” for HIV infection, according to a January 9 announcement by the company.  SB-728-T is a zinc finger DNA-binding protein transcription factor (ZFP TF). It disrupts the gene responsible for making CCR5 co-receptors on the surface of CD4 cells, to which HIV bonds. When CD4 cells can’t produce functional co-receptors, it is much harder for HIV to infect them.  The aim of SB-728-T therapy is to grow a new population of CD4 cells that are resistant to HIV infection, and thus make antiretroviral (ARV) therapy unnecessary. The rationale for using SB-728-T comes from the case of Timothy Brown, an HIV-positive man with leukemia who received two stem cell transplants from a donor who inherited two mutated CCR5 genes (CCR5 delta32), from his father and mother, and was genetically unable to produce CD4 cells that carry functional CCR5 co-receptors. Such individuals rarely become infected with HIV. And in cases where only one mutated CCR5 gene is inherited, HIV infection can occur, but the disease tends to progress slowly.  In Brown’s case, not only did the stem cell therapy cure his cancer, but it also appears to have cured his HIV infection. All efforts to locate HIV in the man’s body have been unsuccessful.

Sangamo is hoping that treating a person’s own stem cells with SB-728-T and then reinfusing them will, over time, replace HIV-susceptible cells with HIV-resistant CD4s and reduce the need for continuous antiretroviral therapy.

The whole story you find on AIDSmeds clicking the following link:

http://www.aidsmeds.com/articles/sangamo_728_studies_1667_21752.shtml

Filed under: HIV and AIDS, HIV Treatment, Medical and Research, , , , , , , , , ,

3. Hamburger HIV – Strategic Forum

Being part of a purely medical symposium is new to me – but it was an interesting one in Hamburg, which ended this afternoon.  Besides my opening talk about the African way in the jungle of Westernized prevention and treatment strategies there were a range of exciting topics  and so much to learn. G Stich from Wuerzburg shared his impression of the treatment work on the continent Africa while K Ochel reported from his experience in working in the fields of E-learning in China. A real eye opener and a complete change of attitude is happening in this huge country, from prevention work via methadone substitute for IV drug-users to treatment options. I realized that maybe we have to review our predictions and thinking regarding China in the fields of HIV and AIDS.
Church, politics and health systems: Is the pandemic under control was the question of a panel discussion I participated then and again: different views how far we have come, but there was nobody seriously thinking we have already reached the Rubicon.

Exciting news from research in the USA: D Ando reported on exciting studies to block the CCR5 receptor and D Margolis from trials to trigger the HIV reservoirs  through HDAC Inhibition. And we learned in the context that there are some interesting developments regarding the Berlin patient. Is functional healing a vision was the overall question of this part of the forum.

The next chapter looked after side effects: Are they really as serious as they sometimes reported? Is there any difference between aging people living with or without HIV or another chronic disease? It seems not according to what I have heard… But I learned that a study about elderly female in Iowa showed that taking too much vitamin supplements actually triggers higher mortality – specially iron. Calcium seems to decrease the mortality rate. Interesting…

Role play about doctor – patient interactions and treatment strategies formed the final part of the forum and I have to admit that the atmosphere, the discussions, the way of giving information, the variety of topics made this strategic forum worth travelling all the way from Cape Town to Hamburg. Thanks also to MSD and the local organisers for making it possible for me to participate, to share my knowledge and to learn so much more.

And good to know that researchers and medics are interested in seeing the holistic picture and eyeing beyond the their own medical portfolio.

Filed under: HIV and AIDS, HIV Prevention, HIV Treatment, HOPE Cape Town Association & Trust, Medical and Research, Networking, Politics and Society, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

POZ Magazine: Cure Watch…

In December 2010, a man was declared cured of HIV. While his example won’t be widely repeated, it could lead to more useful strategies for a cure.
Timothy Ray Brown is “the Berlin patient.” He needed a stem-cell transplant to fight recurrent leukemia. His doctor, Gero Huetter, MD, knew that a small percent of people of northern European ancestry have a genetic variant called double CCR5 delta-32 deletion that seems to protect them from HIV. The virus attaches to CCR5 receptors on CD4 immune cells in order to enter and infect the cells (another attachment protein, CXCR4, is less commonly used). People genetically prevented from producing CCR5 receptors don’t contract HIV despite exposure.
For Brown’s transplant, Huetter found a match who had the genetic variant. After two transplants, Brown found that his HIV receded along with his cancer. Now, nearly four years after the second transplant, he remains free of HIV—without meds.
This cure is not widely useful, and not only because of its expense. Stem cell transplants rank among the most dangerous of medical procedures. Also called bone marrow transplants, they involve wiping out the immune system with high-dose radiation and chemotherapy before infusing stem cells from a donor. The body then grows a new immune system matching the donor’s. During chemo and radiation and before the new immunity takes hold, the recipient is vulnerable to infections and at serious risk of organ damage and other life-threatening conditions. There is also significant danger that the recipient’s body will reject the transplant.
Yet Brown’s case opens vistas for HIV eradication. While meds (entry inhibitors) blocking CCR5 attachment are in the HIV-treatment arsenal, they do not erase the virus and must be taken continuously. Brown’s experience shows that if CCR5 receptors can be genetically altered, the virus might be wiped out, making a lifetime of HIV meds unnecessary.
Researchers are working on exactly that, using technology called “zinc finger DNA-binding protein nuclease” to modify CD4 cells to match those of people with the double CCR5 delta-32 deletion. Several current studies ask whether infusing such cells—without the life-threatening transplant—will allow the Berlin cure to go global.

POZ magazine original article

Filed under: HIV and AIDS, HIV Treatment, Medical and Research, , , , ,

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